Page 6 - Benefits Guide BICS 2020 Final

Medical Insurance

As a benefit-eligible employee of BICS, you have three choices available for medical coverage: HMO, EPO and HDHP. All medical
plans provide you with in-network preventive care covered at 100%. Preventive care includes your annual wellness exam and any
tests and immunizations recommended for you based on your age and gender.

The HMO is an in-network only plan, available to employees located in California, that requires you to select a primary care
physician (PCP)/medical group. Your PCP manages your whole health and for this reason you must receive a referral to obtain
care from a specialist. Each member of your family may select a different PCP or medical group. When selecting a PCP, it is a good
idea to review the entire medical group that the PCP is affiliated with and also the hospitals to which they have admitting
privileges to ensure you are happy with the resources available to you. It is also important to understand that Urgent Care must
be provided by the facility affiliated with your medical group. While HMO limits coverage to in-network only, in the event of an
emergency, both in-network and out-of-network care is covered.

The EPO (Exclusive Provider Organization) is a plan that provides in-network coverage only with no need to select a primary care
physician. Our EPO plan provides you with access to the full PPO network and includes copays for office visits and urgent care.
This plan requires that you only utilize doctors, clinics, and hospitals that belong to the network, except in the case of an
emergency. If you choose to see a provider who is not part of the network, you will be required to pay the full cost for your care.

The PPO High Deductible Health Plan (HDHP) works the same as a traditional PPO by providing options for care both in-network
and out-of-network. This plan has a high deductible that must be met up front before the plan begins sharing in the cost of
services; this includes prescription drugs. The copays listed for prescription drugs do not apply until the deductible has been met.
Your annual preventive wellness exam is still a 100% covered benefit, but everything else is subject to you meeting your
deductible first before the coinsurance applies. The HDHP plan meets the IRS criteria to allow you to open a Health Savings
Account (HSA).

Which Option is Right for You?

HMO EPO PPO HDHP
Annual Deductible None $ $$$
BICS HSA Contribution N/A N/A Yes

Employee HSA Contribution N/A N/A Yes
In-Network Coinsurance N/A You pay 20% You pay 20%
Out-of-Pocket Maximum $ $$$ $$
Prescription Drugs $5/$15/$30/$50 $5/$15/$30/$50 Plan deductible applies, then $5/$15/$40/$60

Health Care FSA Enrollment Available Available Available with restrictions

Finding a Medical Provider
• Go to www.anthem.com/ca
• Select “Find a Doctor”
• Search as a ‘Guest by Selecting a Plan’ and answer the questions:
• What type of plan do you want to search with: “Medical (Employer-Sponsored)”
• Select a plan/network:
 HMO: State: CA only | Plan/Network: Blue Cross HMO (CA Care) - Large Group
 EPO or PPO/HDHP: State: CA | Plan/Network: Blue Cross PPO (Prudent Buyer) - Large Group
 EPO or PPO/HDHP: State: Non-CA | Plan/Network: National PPO (BlueCard PPO)

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